Speech Deterioration in Amyotrophic Lateral Sclerosis A Case Study Case Study
Case Study  |   December 01, 1991
Speech Deterioration in Amyotrophic Lateral Sclerosis
 
Author Affiliations & Notes
  • Raymond D. Kent
    Department of Communicative Disorders University of Wisconsin-Madison
  • Robert L. Sufit
    Department of Neurology Center for Health Sciences University of Wisconsin-Madison
  • John C. Rosenbek
    Veterans Administration Hospital Madison, WI
  • Jane F. Kent
    Department of Communicative Disorders University of Wisconsin-Madison
  • Gary Weismer
    Department of Communicative Disorders University of Wisconsin-Madison
  • Ruth E. Martin
    Department of Communicative Disorders University of Wisconsin-Madison
  • Benjamin R. Brooks
    Department of Neurology Center for Health Sciences University of Wisconsin-Madison
  • Requests for reprints should be sent to R. D. Kent, PhD, Department of Communicative Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, Wl 53706.
Article Information
Speech / Case Study
Case Study   |   December 01, 1991
Speech Deterioration in Amyotrophic Lateral Sclerosis
Journal of Speech, Language, and Hearing Research, December 1991, Vol. 34, 1269-1275. doi:10.1044/jshr.3406.1269
History: Received January 2, 1990 , Accepted January 6, 1991
 
Journal of Speech, Language, and Hearing Research, December 1991, Vol. 34, 1269-1275. doi:10.1044/jshr.3406.1269
History: Received January 2, 1990; Accepted January 6, 1991

Few detailed reports have been published on the nature of speech and voice changes during the course of amyotrophic lateral sclerosis (ALS). The subject of this case study is a woman who was diagnosed as having ALS with bulbar signs at the age of 53. Speech intelligibility, pulmonary function, and selected speech and voice functions were tested during an approximately 2-year course of her disease. Over this period, her speech intelligibility, as measured by a multiplechoice word identification test, declined from 98% to 48%. Phonetic features that were most affected during the intelligibility decline included voicing contrast for syllable-initial and syllablefinal consonants, place of articulation contrasts for lingual consonants, manner of articulation for lingual consonants, stop versus nasal manner of production, features related to the liquid consonants, and various features related to syllable shape. An acoustic measure, average slope of the second-formant frequency, declined in association with the intelligibility reduction and is thought to reflect the loss of lingual motoneurons. Her pulmonary function also declined over the observation interval, with particularly severe reduction in measures of air flow. Oral diadochokinesis and measures of vocal function (including jitter, shimmer, and signal-to-noise ratio) were highly variable across test sessions. These results are discussed in terms of the challenges they present to sensitive assessment of change and to management of the communication disability in ALS.

Acknowledgements
This work was supported in part by Research Grant DC00319 from the National Institute on Deafness and Other Communication Disorders; Clinical Investigator Development Award K08 DC00018 (author RLS); and the Amyotrophic Lateral Sclerosis Clinical Research Center, Department of Neurology, Center for Health Sciences, University of Wisconsin-Madison.
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